My D - need some help please

[mum2westiesGill]

As this is rather an extreme situation (your late evening highs AND your huge drops overnight) in your shoes I think I *would* change both things at once.

Hi Mike,
Hope you're still around somewhere on here before teatime & bedtime 😱 - So which both things do you mean?

Incidentally... dont forget that you don't need to worry about the maths any more, so there's no need to change from 1:10gCHO to 1.5:10gCHO (a 50% increase) you can set the Expert to calculate 1.1:10g or 1.2:10g and it will do all the tricky calculations to you, so you only need to change things quite carefully rather than risking exchanging highs at bedtime for hypos all evening!

Cheers thank you very much for letting me know this 🙂

If I was changing any ratio eg the evening meal one which time block would I go to please?
my time blocks:
0.00 5.30
5.30 12.00
12.00 16.00
16.00 21.30
21.30 0.00

 

[mum2westiesGill]

I always try to ensure that my evening meal dose (and therefore my meal) is around 5 hours before bed. That way I can be more or less sure that any drop is due to basal problems and that is what I would need to look at.

Thank you 🙂

 

[everydayupsanddowns]

Hi there, sorry didn't see this earlier.

Hi Mike,
Hope you're still around somewhere on here before teatime & bedtime 😱 - So which both things do you mean?

Thing 1 - You seem to have too much basal active at night (because even though you go to bed really high, you then drop a very long way when your meal dose should be finished).
Thing 2 - Your level at bedtime is too high. This *might* indicate that your evening meal dose is too low. On other moths though it is down to a small snack but no insulin.

Cheers thank you very much for letting me know this 🙂

If I was changing any ratio eg the evening meal one which time block would I go to please?
my time blocks:
0.00 5.30
5.30 12.00
12.00 16.00
16.00 21.30
21.30 0.00

Depends when you eat. 16.00-21.30 (ie 4pm - 9.30pm) would cover my evening meal times. If that's the case for you, then you could try a small tweak there?

Are you planning on chatting these through with DSN?

 

[mum2westiesGill]

Thu 24.10.2013
6.6 - 10:51 - breakfast - 3.0 CPs - 3.5u QA
8.7 - 14:53 - lunchtime - 4.5 CPs - 5.5u QA
10.0 - 18:55 - teatime - 4.0 CPs - 5.5u QA
7.7 - 23.11 - bedtime -3.0 CPs - 0 QA - no QA taken because i don't like taking QA before goping to bed to sleep
- 23:11 - BI -24u
no snacking during the evening

Fri 25.10.2013
10.5 - 10:40 - breakfast - 1.5 CPs - 3u QA
4.7 - 14:33 - lunchtime - 4.5 CPs - 4u QA
9.8 - 18:59 - teatime - 2.0 CPs -4.5u QA
4.3 - 22:58 - bedtime -8.1 CPs - 0 QA - wow! 😱 😱 a lot of CPs there I know it involved:
sandwich(chse sprd) 2 slcs(30g)/discos 28g pkt/rich tea biscuits 2(11.8g)/choc digestive 2(21.6g)(81g) - I was in a very hungry mood - no other snacking during the evening
- 23:11 - BI -24u

Sat 26.10.2013
4.3 - 10:24 - breakfast - 1.5 CPs - 1u QA

 

[Northerner]

It's looking to me like you have too much basal overnight Gill. Without the food you would have been in a bit of trouble I suspect. From Friday night to Saturday morning you needed 80g of carbs in order to wake at the same level you went to bed at 😱

Having said that it's difficult to know how you can achieve predictable results overnight if you are eating variable amounts of carbs not covered by QA insulin (and I perfectly understand you not wanting QA before bed). Presumably you wish to continue eating before bed with no QA, in which case you will be relying on your basal to bring levels down. If your basal level was set to a dose that just dealt with your liver's output overnight then you would wake with very high levels. You could find out what your basal overnight needs should be by eating nothing at all after your evening meal and testing through the night (since without the extra carbs you basal dose would probably be too high). But as soon as you start having carbs before bed again your waking numbers will be high.

Does that make sense?

 

[mum2westiesGill]

Does that make sense?

So nothing at all to eat from evening meal onwards until the next morning 😡? I can try it not tonight but in the next couple of nights.

I went ahead last night with the changing of the teatime i:c ratio and changed it from 1:1 (1u of insulin to every 10g carbs) to 1.5u:1 (1.5u to every 10g carbs). I've got plenty of jelly babies to hand . I'm going to give it 5/6 days to 1 week & see how things are going. I can always monitor more often.

 

[Northerner]

So nothing at all to eat from evening meal onwards until the next morning 😡? I can try it not tonight but in the next couple of nights. ...

Well, in an ideal world you would establish exactly what your basal requirements are overnight by not eating after your evening meal and then testing and adjusting your basal until it keeps you at a good, steady level overnight. Then you would need to work out what QA insulin you need (and what ratio) for the supper you are going to eat and inject for it. So, the basal should (in theory) match your liver's output, and te QA would match what you eat before bed.

When I was first diagnosed I used to drop quite a lot overnight so had to eat to keep my levels up. Once I had reduced my basal so that I didn't need to eat I just stopped having anything carby after my evening meal because, like you, I didn't want to inject before bed.

 

[mum2westiesGill]

Sat 26.10.2013
4.3 - 10:24 - breakfast - 1.5 CPs - 1u QA
8.5 - 15:48 - lunchtime - 4.2 CPs - 5u QA
13.4 - 19:53 - teatime - 3.0 CPs - 5u QA - should've been an extra 2u correction but I didn't do this correction as I was going for an evening out involving alcohol - maybe approx 4 whisky & diet cokes & 1 smirnoff ice
10.5 - 22:32 - bedtime - 24u BI - 8.7 CPs - 0 QA - wow! another night with a lot of CPs there, it was due to a Mcdonald's on the way home which involved:
mayo chkn(38g)/smarties McFlurry(49g)(87g)